Tumor immune checkpoint inhibitors (ICIs) present a dual nature, offering therapeutic benefits alongside possible toxic side effects. Despite their significant clinical advantages, immune-related adverse events (irAEs) are major concern. In particular, the multi-organ irAEs (MO-irAEs) caused by ICIs present complex clinical manifestations, affecting a high proportion of critically ill patients. There is a lack of clinical awareness and attention towards these adverse events, making management relatively difficult, thus potentially threatening the life of patients. Reasonable application of hormones and immune modulators, along with symptomatic and supportive treatment, as well as careful monitoring and long-term follow-up are crucial measures to control MO-irAEs. Clinical characteristics, peripheral blood indicators, and genetic predisposition can serve as predictive markers for MO-irAEs occurrence and progression to some extent. A comprehensive understanding of clinical features, intervention measures, prognosis, potential molecular mechanisms and predictive factors of MO-irAEs can help to effectively control MO-irAEs, ultimately improving patient outcomes.

Objective To analyze the correlation between high signal intensity of infrapatellar fat pad(IPFP)and symptoms and structural changes of osteoarthritis of the knee in patients with osteoarthritis of the knee based on image digitization.Methods Imaging and clinical data of patients with knee osteoarthritis(KOA)were retrospectively analyzed.The differences in knee osteoarthritis symptoms and structural changes in patients with different IPFP high signal intensities were compared,and the relationship between IPFP high signal intensity changes and knee osteoar-thritis symptoms as well as structural changes was also analyzed.Results A total of 219 patients(268 knees)were collected and completed imaging measurements and evaluations,and the median IPFP high signal intensity(27.40％)was used to compare the groups.The IPFP high signal intensity ≥ 27.40％group had a significantly higher degree of tibial cartilage damage,changes in knee angle,pain,and total scores on the osteoarthritis index(western ontario and mcMaster).universities osteoarthritis index(WOMAC)were significantly higher than those in the IPFP high signal intensity＜27.40％group,with a statistically significant difference(P＜0.05);IPFPF high signal inten-sity changes were associated with knee pain,joint line convergence angle,JLCA,and knee joint angle.Angle(JLCA),knee kellgren-Lawrence(KL)classification,and the degree of femoral and tibial cartilage damage were significantly positively correlated(P＜0.05).Conclusion In patients with KOA,there is a significant correlation between IPFP high signal intensity changes and knee pain symptoms as well as structural changes,which may be an important factor influencing the progression of KOA.

Objective To analyze the correlation between high signal intensity of infrapatellar fat pad(IPFP)and symptoms and structural changes of osteoarthritis of the knee in patients with osteoarthritis of the knee based on image digitization.Methods Imaging and clinical data of patients with knee osteoarthritis(KOA)were retrospectively analyzed.The differences in knee osteoarthritis symptoms and structural changes in patients with different IPFP high signal intensities were compared,and the relationship between IPFP high signal intensity changes and knee osteoar-thritis symptoms as well as structural changes was also analyzed.Results A total of 219 patients(268 knees)were collected and completed imaging measurements and evaluations,and the median IPFP high signal intensity(27.40％)was used to compare the groups.The IPFP high signal intensity ≥ 27.40％group had a significantly higher degree of tibial cartilage damage,changes in knee angle,pain,and total scores on the osteoarthritis index(western ontario and mcMaster).universities osteoarthritis index(WOMAC)were significantly higher than those in the IPFP high signal intensity＜27.40％group,with a statistically significant difference(P＜0.05);IPFPF high signal inten-sity changes were associated with knee pain,joint line convergence angle,JLCA,and knee joint angle.Angle(JLCA),knee kellgren-Lawrence(KL)classification,and the degree of femoral and tibial cartilage damage were significantly positively correlated(P＜0.05).Conclusion In patients with KOA,there is a significant correlation between IPFP high signal intensity changes and knee pain symptoms as well as structural changes,which may be an important factor influencing the progression of KOA.

The traditional-immunological strategies for clinical laboratories often rely on large and expensive instruments and skilled operators, and the measurement time is also long. However, the sensitivity of these strategies is still unsatisfactory. It is urgent to research and develop the point-of-care testing (POCT) featured as a highly sensitive, accurate, and rapid/POCT diagnosis. The Microfluidic chips have multi-advantages that are suitable for the clinical POCT diagnosis: high sensitivity, throughput, and automation. Recently, the Microfluidic-immune chips developed based on the microfluidic technology combined with immune detection have considered not only hotspots in the related research but also benefit to the tumor marker detection, antigen and antibody detection of infectious diseases, autoantibody detection, hormone detection, and other fields. However, there are still many challenges to be overcome during the application of chips, such as more effective microfluidic manipulation, more sensitive collection, and analysis of reaction signals.

Objective To investigate the allele distribution, population genetics parameters and genetic analysis of neighboring populations of 19 autosomal STR loci in Sichuan Han population, and to evaluate their forensic application value. Methods The Goldeneye?? DNA ID system 20A was used to perform multiplex PCR amplification and allelic gene typing of 19 STR loci in 1 201 unrelated Han individuals from Sichuan Province. Allele frequencies and population genetics parameters were calculated. The Nei's genetic distances between Sichuan Han population and 12 previously reported populations were analyzed. Multidimensional scaling and principal component analysis were carried out and phylogenetic trees were also constructed. Results The heterozygosity of 19 STR loci ranged from 0.617 0 to 0.915 1, their discrimination power ranged from 0.777 4 to 0.986 5, matching probability ranged from 0.013 5 to 0.222 6, polymorphism information content ranged from 0.546 4 to 0.910 5, probability of exclusion ranged from 0.311 8 to 0.826 3 （triplet） and from 0.197 9 to 0.712 1 （biplet）, and no significant deviations from Hardy-Weinberg equilibrium were observed. Based on the results of multidimensional scaling, principal component analysis and phylogenetic trees of the genetic distances between Sichuan Han population and the other 12 populations, Sichuan Han population was closest to Hubei Han population and was farthest to Xinjiang Uygur population. Conclusion The 19 autosomal STR loci showed a high polymorphism and discriminating ability in Sichuan Han population, which can provide a data foundation for personal identification, paternity test and population genetics study.
Asian People/genetics* ; China ; Ethnicity/genetics* ; Gene Frequency ; Genetics, Population ; Humans ; Microsatellite Repeats ; Phylogeny ; Polymorphism, Genetic

Objective:To explore the role of clinical pharmacists in the drug treatment of one patient with rheumatoid arthritis and severe pneumonia. Methods: The drug treatment of one patient with rheumatoid arthritis and severe pneumonia involved in clinical pharmacists was retrospectively analyzed. Clinical pharmacists provided rational suggestions for the adjustment of anti-infection treat-ment,selection of medication, evaluation of therapeutic effect and monitoring of adverse drug reactions. Results: Clinical pharmacists participated in the whole medication treatment process, and their suggestions on anti-infection drugs choices, dose adjustment and ad-verse reactions treatment were accepted by doctors. Conclusion:Taking use of self professional competence, clinical pharmacists play a positive role in the optimization and adjustment of drug treatment regimen, which provides security for the medication safety and clini-cal rational drug use.

Objective: To reveal the harm seriousness of bug bites induced rhabdomyolysis complicated with acute renal failure to human body and provide case evidence for clinical workers to improve the understanding and treatment level of insect bites related diseases.Methods: The clinical diagnosis and treatment of one case of insect bites induced rhabdomyolysis complicated with acute renal failure was tracked, and the individualized diagnosis and treatment were performed and summarized according to the clinical symptoms and the conditions of the patient.Results: All the indicators of the patient returned to normal with satisfactory curative effect and promising prognosis.Conclusion: The treatment of rhabdomyolysis complicated with acute renal failure needs quick identification and reversible factors correction, which are beneficial to the improvement of organ function and prognosis.

This article reports the successful experience of integration of burn treatment and rehabilitation for a child suffering from 91% TBSA flame burn injury (with 60% TBSA full-thickness injury, 30% TBSA deep partial-thickness injury, and 1% TBSA superficial partial-thickness injury), severe inhalation injury, severe burn shock, stress ulcer, gastrointestinal bleeding and atelectasis of the right upper lung. The patient was given effective fluid infusion against shock, treatment for gastrointestinal bleeding, and other effective supportive treatment for functions of various organs after being admitted to our burn ward. When vital signs became stable at 30 hours post injury, bedside rehabilitation was begun. On post injury day (PID) 4, escharectomy was performed for both lower limbs, followed by microskin grafting and allogeneic skin covering. On PID 10, invasive infection of multi-drug resistant bacteria was found with accompanied high fever, and at the same time allograft began to disintegrate, with dissolution of large area of eschar, leading to a raw surface reaching 86% TBSA. Following debridement, dressing, application of compound polymyxin B ointment, temporary covering of wounds with porcine acellular dermal matrix, adjustment of antibiotics, patient's condition was finally stabilized. From PID 28 on, split-thickness skin grafting was conducted 7 times, and the raw surface of 75% TBSA involving the upper and lower limbs and trunk was successfully covered. At the same time, our rehabilitation team launched comprehensive rehabilitation measures comprising active exercise, occupational therapy, prevention of scar formation, organ function training and psychological intervention. Finally, the patient was able to walk unaided and fed herself when the wounds were almost entirely healed in 3 months after injury. Oriented forwards functional rehabilitation, strong cooperation between team members, and synchronous effective implementation of burn treatment and rehabilitation in the whole process are the keys to achieve successful integration of burn treatment and rehabilitation of this child.
Acellular Dermis ; Animals ; Anti-Bacterial Agents ; therapeutic use ; Burns ; rehabilitation ; therapy ; Cicatrix ; Debridement ; Humans ; Shock ; complications ; Skin ; Skin Transplantation ; Swine ; Trauma Severity Indices ; Treatment Outcome ; Wound Healing

Glycyrrhizin is the major bioactive compound in Glycyrrhiza uralensis. Farnesyl-diphosphate synthase (FPS) is one of the major enzymes involved in the glycyrrhizin biosynthetic. We cloned the full length of FPS coding sequence based on the transcriptome data of G. uralensis. The FPS gene of G. uralensis (GlyurFPS) is 1029 bp, coding 342 amino acid. The homology between the sequence of its protein and that of the FPS in Cicer arietinum, Medicago sativa, Medicago truncatula, Glycine max, Lotus japonicus was of 94%, 94%, 93%, 93% and 92%, respectively. Plant FPS gene is very conservative, therefore the phylogenetic tree is same with the plant classification consistent.

As a pilot program of teaching reform,some excellent undergraduates majoring in nursing were selected to take specialized courses in ICU in order to cultivate the intensive care specialized nurses.The teaching team of specialized courses in ICU was established to guarantee the teaching quality.The team was in charge of the ICU specialized curriculum building,textbooks selection and teaching content examination.The high leveled teaching team of specialized courses in ICU was organized by taking teaching and researching section as a unit to improve theoretical teaching level,using clinical department as training base to enhance practice skill and participating in special subject classes and in-service study to promote specialized quality.